38例重症SARS患者临床救治回顾分析

Clinical therapy of severe acute respiratory syndrome: 38 cases retrospective analysis

目的 :探讨 ICU救治重症严重急性呼吸综合征 (SARS)患者的临床特点以及经验。方法 :回顾分析2 0 0 2年 12月— 2 0 0 3年 4月 38例入住 ICU救治的重症 SARS患者的临床资料。初步分析治疗与预后的因果关系。结果 :38例重症 SARS患者中 ,合并有基础疾病者 8例 (2 1.1% )。起病初期均给予抗病毒对症支持和器官保护治疗 ,发展至重症阶段均给予抗生素、糖皮质激素抗炎、营养支持、免疫调节、人工通气辅助等治疗措施。30例最终病愈出院 (78.9% ) ,其中 11例出院时 X线胸片示有轻微的肺纤维化改变 (36 .7% ,11/30 ) ;8例死亡(病死率 2 1.1% )。结论 :重症 SARS病情发展迅速 ,除了提倡早诊断、早隔离、早治疗外 ,合理使用糖皮质激素和人工通气辅助效果理想。

Objective: To analyze the clinical features and therapy experience of severe acute respiratory syndrome (SARS). Methods: From December 2002 to April 2003 in Guangzhou Institute of Respiratory Disease, 38 patients with severe SARS were retrospectively studied to evaluate the relationship between treatment strategy and prognosis.Results: Thirtyeight cases of severe SARS were diagnosed. Comprehensive measures most commonly included corticosteroids, antibiotics, antivirotics, nutritional support and mechanical ventilation. Thirty cases were cured (78 9%), of them 11 cases had pulmonary fibrosis(36 7%), 8 patients died(21 1%) in all cases. Conclusion: Severe SARS might develop rapidly. In addition to early diagnosis, prompt isolation, and emergency therapy,appropriate use of corticosteroid and noninvasive ventilation should be recommended.